When considering priority setting of problems, the nurse keeps in mind that second-level priority problems include which of these aspects?

Correct Answer: C

Rationale: The correct answer is C: Abnormal laboratory values. Second-level priority problems are those that require attention after addressing first-level problems but before third-level problems. Abnormal laboratory values fall into this category because they may indicate a potential for worsening health conditions if left untreated. Low self-esteem (choice A) is typically a third-level priority, lack of knowledge (choice B) can usually be addressed as a lower priority, and severely abnormal vital signs (choice D) are considered first-level priorities due to their immediate threat to the patient's well-being.

Correct Answer: C

Rationale: The correct answer is C, a complete health data base. In this initial home visit for a patient with chronic medical problems, the nurse's primary responsibility is to gather comprehensive information about the patient's health status, medical history, current medications, social support, and lifestyle factors. This type of data base allows for a holistic assessment and forms the foundation for ongoing care planning and monitoring. Choice A is incorrect because a follow-up data base is not suitable for an initial visit as it focuses on evaluating changes over time. Choice B is incorrect as an episodic data base is more appropriate for acute, single-issue visits. Choice D is incorrect as an emergency data base is used in urgent situations requiring rapid assessment and treatment, not for a routine initial visit for chronic medical problems.

Correct Answer: B

Rationale: The correct diagnosis for this patient is external otitis (choice B). The key findings that support this diagnosis include pain on manipulation of the ear, especially the tragus, narrowed and erythematous ear canal, drainage, and white debris in the canal. These are classic signs of external otitis, also known as swimmer's ear, which is an infection of the ear canal. Otitis media (choice A) typically presents with middle ear inflammation and fluid accumulation, but this patient's symptoms are more consistent with an external ear infection. Perforation of the tympanum (choice C) would present with different symptoms, such as hearing loss, ear discharge, and possible pain, but the examination findings described do not suggest a perforation. Cholesteatoma (choice D) is a benign growth in the middle ear and does not typically present with the external ear canal findings described in the patient.

Correct Answer: A

Rationale: The correct answer is A: Obtain an abdominal ultrasound. A pulsatile mass in an elderly smoker raises concern for an abdominal aortic aneurysm (AAA). An abdominal ultrasound is the best initial diagnostic test to confirm the presence of an AAA. If left untreated, AAA can lead to life-threatening complications such as rupture. Choice B (Reassess in 6 months) and C (Reassess in 3 months) are incorrect as immediate investigation is necessary due to the potential seriousness of an AAA. Choice D (Refer to a vascular surgeon) is premature without confirming the presence of an AAA through imaging. An ultrasound is needed first to guide further management.

Correct Answer: A

Rationale: The correct answer is A: Palpation. Palpation involves using the hands to feel for abnormalities such as crepitus (crackling or grating sensation), swelling, and pulsations. It allows the nurse to assess textures, temperatures, and tenderness. Inspection (B) involves visual examination, which may not detect subtle abnormalities like crepitus. Percussion (C) is tapping on the body to assess underlying structures and is not used for detecting crepitus, swelling, or pulsations. Auscultation (D) involves listening with a stethoscope and is used for assessing sounds like heartbeats or breath sounds, not the physical characteristics mentioned in the question.